Ren Zhiyuan, Guo Wenxing, Li Junjing, Cheng Yuangui, Jiang Wen, Wang Wei, Gao Min, Wu Wen, Pan Ziyun, Yang Ying, Pearce Elizabeth N, Dong Shuyao, Wang Chongdan, Zhang Wanqi
Department of Nutrition and Food Hygiene, Tianjin Medical University, Tianjin, China.
Gaoqing County People's Hospital of Shandong Province, Shandong, China.
J Nutr. 2025 Jul;155(7):2069-2075. doi: 10.1016/j.tjnut.2024.12.024. Epub 2024 Dec 28.
Both iodine deficiency and iodine excess can harm the thyroid glands during pregnancy. In areas without iodine fortification, the relationship between the water iodine concentration (WIC) and thyroid disease in pregnant women requires further investigation.
The aim of this study was to evaluate the relationship between WICs and the prevalence of thyroid disease in pregnant women residing in areas with high WICs without access to iodized salt.
A cross-sectional survey was conducted in Shandong Province. Water and urine samples were collected, and the iodine content was assessed. Venous blood samples were taken to measure thyroid hormones and antibodies. Ultrasound was used to assess thyroid size and detect nodules.
A total of 1073 pregnant women were included in this study. As the WIC increased, the urinary iodine concentration also increased, according to linear regression analysis (β: 0.5; P < 0.001). The lowest prevalence of subclinical hypothyroidism (SH) and thyroid dysfunction (TD) was observed at a WIC of 10-40 μg/L, whereas the lowest prevalence of thyroid nodules (TNs) and goiter was seen at a WIC of 40-100 μg/L. Logistic regression analysis showed that WIC was significantly associated with thyroid diseases. WIC of <10 μg/L was associated with TD prevalence (OR: 1.8; 95% CI: 1.1, 3.1), and WIC of >100 μg/L was associated with SH, TN, and goiter prevalence (SH-OR: 10.8; 95% CI: 1.4, 84.0; TN-OR: 2.5; 95% CI: 1.1, 5.6; goiter-OR: 2.4; 95% CI: 1.1, 5.6).
WIC is associated with thyroid function among pregnant women. WIC of <10 μg/L is a risk factor for TD, whereas WIC of >100 μg/L is a risk factor for SH, TN, and goiter. These findings suggest that intermediate WICs are most conducive to thyroid health in pregnant women and that assessing local WICs could help improve maternal health.
碘缺乏和碘过量在孕期均会损害甲状腺。在未实施碘强化的地区，孕妇水碘浓度（WIC）与甲状腺疾病之间的关系有待进一步研究。
本研究旨在评估生活在高水碘地区且无法获取加碘盐的孕妇中，水碘浓度与甲状腺疾病患病率之间的关系。
在山东省开展了一项横断面调查。采集了水和尿液样本，并评估碘含量。采集静脉血样本以检测甲状腺激素和抗体。使用超声评估甲状腺大小并检测结节。
本研究共纳入1073名孕妇。线性回归分析显示，随着水碘浓度升高，尿碘浓度也升高（β：0.5；P < 0.001）。亚临床甲状腺功能减退（SH）和甲状腺功能障碍（TD）患病率在水碘浓度为10 - 40μg/L时最低，而甲状腺结节（TNs）和甲状腺肿患病率在水碘浓度为40 - 100μg/L时最低。逻辑回归分析表明，水碘浓度与甲状腺疾病显著相关。水碘浓度<10μg/L与TD患病率相关（比值比：1.8；95%置信区间：1.1，3.1），水碘浓度>100μg/L与SH、TN和甲状腺肿患病率相关（SH - 比值比：10.8；95%置信区间：1.4，84.0；TN - 比值比：2.5；95%置信区间：1.1，5.6；甲状腺肿 - 比值比：2.4；95%置信区间：1.1，5.6）。
孕妇的水碘浓度与甲状腺功能相关。水碘浓度<10μg/L是TD的危险因素，而水碘浓度>100μg/L是SH、TN和甲状腺肿的危险因素。这些发现表明，中等水平的水碘浓度最有利于孕妇的甲状腺健康，评估当地的水碘浓度有助于改善孕产妇健康。
